This example is extremely important for all brachycephalic owners as well as veterinarians to take into consideration. Initial surgeons did a basic surgery, nares opening and palate shortening, citing absolutely nothing else could be done upon a poor initial result. Sent to another specialist, they disagreed suggesting the saccules and tonsils should be removed, the nares opened wider than the first surgery, and the palate shortened a lot more and also thinned. This demonstrates the importance of understanding the meaning or a pro-active 5/5 surgeon as opposed to a surgeon that may do all 5 aspects only if really necessary (often synonymous with the fact the don’t really do them). Our own clinic does many revision assessments demonstrating the same problem, a difference of opinion of what does and does not need to be done.
Specialists had worked on Winston’s vomiting for 6 months without result before he came to see us. Post BOAS surgery the vomiting was 95% improved. Snoring and exercise noise were also significantlyreduced, and exercise tolerance massively improved. This is a classic example of our recommendations not to bother working up vomiting unless still of concern after airway correction, as it’s almost always related to restricted airways.
Marley had early BOAS surgery with little response, then spent a year at specialists trying to work up why he was vomiting. A typical case of why we start by keeping everything simple, Marley had only had 2/5 airway correction, hence we started with a revision 5/5 surgery. He needed all 5 aspects done (and re done) and his improvements across the board were dramatic (including vomiting). His case highlights the option of just doing appropriate 5/5 airway correction before spending 12 months in and out of specialists doing exhaustive tests to try to work out what’s going on.
Similar to Marley, Harley had unsuccessful BOAS surgery at a specialists at about two years of age. Revising her palate via further shortening and thinning and deepening the nares, the improvements were significant. Hence revision assessment always remains an option if initial surgery has not given a good result.